What is Dexmethylphenidate?

Attention-deficit/hyperactivity disorder (ADHD) was once thought to be a childhood disorder, but is now recognized to affect many adults in the US today. You can learn more about ADHD and its symptoms by checking the NIMH ADHD treatment overview.

There are various medication options available for treating ADHD symptoms, including both stimulant and non-stimulant medications. One stimulant ADHD medication option is dexmethylphenidate.

Dexmethylphenidate, an ADHD medication, is the generic for the brand names Focalin and Focalin XR. It is a central nervous system (CNS) stimulant drug that is FDA-approved to treat ADHD in children ages 6 and older, adolescents, and adults. Dexmethylphenidate is used to treat symptoms of ADHD, such as distractibility, difficulty concentrating, restlessness, and impulsivity.

According to the DEA controlled substance schedules, dexmethylphenidate is a Schedule II controlled substance due to its potential for abuse, misuse, and development of a substance use disorder. ADHD Advisor only treats adults 18 years of age or older.

How Dexmethylphenidate Works

The Focalin generic drug, dexmethylphenidate, is a CNS stimulant used to treat symptoms of ADHD.  It works for ADHD symptoms by blocking the reabsorption or reuptake of the neurotransmitters: dopamine and norepinephrine. 

By blocking the reabsorption of these two neurotransmitters, the brain—primarily the prefrontal cortex—gains greater access to them, allowing it to remain active for longer periods. This results in an increased ability to focus, pay attention, and reduce impulsivity. 

Dexmethylphenidate is the active d-isomer of methylphenidate. Single isomers tend to have fewer side effects than mixed isomer preparations.

Traditional methylphenidate, commonly known as Ritalin, contains both the active d-isomer and an inactive l-isomer. By isolating the active d-isomer, dexmethylphenidate allows for a lower dosage and possibly causes fewer side effects than the racemic version.

Who Can Take Dexmethylphenidate

Dexmethylphenidate ADHD medication is FDA-approved to treat children aged 6 and older, adolescents, and adults with ADHD. This includes both the immediate-release and the extended-release versions of the medication. It's important to mention that ADHD Advisor only treats adults aged 18 and older for ADHD.

Dexmethylphenidate is not for everyone. It is a Schedule II controlled substance, which means that it has a high potential for abuse, misuse, and addiction. Please inform your doctor of any alcohol or drug dependence before starting dexmethylphenidate.

Contraindications

There are some contraindications with to be aware of with dexmethylphenidate ADHD medication. For one, anyone with an allergy to dexmethylphenidate or any of the ingredients in this medication should not take it, as dangerous allergic reactions can occur. You also shouldn't take dexmethylphenidate if you:

• Have glaucoma
• Have tics
• Have Tourette's syndrome
• Take any MAOIs
• Have severe anxiety
• Have bipolar disorder or a psychotic disorder
• Have hyperthyroidism
• Have a history of stroke

Cardiovascular Risks

Dexmethylphenidate can increase your heart rate and blood pressure; therefore, there are some cardiovascular risks to be aware of, especially if you already have a heart condition. Some cardiovascular risks include:

• Developing arrhythmia
• Worsening heart conditions
• Chest pain
• A rapid increase in blood pressure in people with hypertension
• Sudden death in those with structural heart disease

Dosages and Administration

Let's take a look at the dexmethylphenidate dosage for ADHD. Remember, only a licensed clinician can safely determine the right dosage for you.

The immediate-release dexmethylphenidate starts at 2.5-5mg twice a day. Each dose is taken about 4 hours apart. Your doctor may gradually increase the dose up to a maximum of 20 mg per day. Doses are typically taken in the morning and around noon to prevent unwanted sleep problems from taking an evening dose.

Dexmethylphenidate XR is usually started at 10 mg/day and slowly titrated up to a maximum of 40 mg/day. It is taken only once a day and should be taken in the morning to avoid insomnia at night.

Doses of dexmethylphenidate for ADHD are tailored to each individual, and these are average starting points. Dosing adjustments will be determined by your healthcare provider. You can consult the FDA dexmethylphenidate prescribing information to learn more.

Side Effects and Risks

As with any new medication, there may be some side effects to consider. To learn more about potential side effects, you can consult with DailyMed: dexmethylphenidate. Let's take a look at some common and serious dexmethylphenidate side effects.

Common Side Effects

Some of the common side effects associated with dexmethylphenidate include: (MedlinePlus: dexmethylphenidate)

• Insomnia
• Racing heart
• Dizziness
• Increased blood pressure
• Sore throat
• Mood changes
• Decreased appetite
• Dry mouth
• Headache
• Anxiety
• Upset stomach

Serious Side Effects

Some more serious side effects can occur from taking dexmethylphenidate. These include:

• Increased heart rate and blood pressure
• Hallucinations and delusions
• Increased mania
• Psychosis and paranoia
• New or worsening tics
• Raynaud's phenomenon
• Slowed growth in children
• Addiction
• Overdose
• Stroke
• Heart attack
• Sudden death

If you experience any serious side effects, please let your medical professional know immediately. You can also report any adverse effects to the FDA's MedWatch program

FDA Boxed Warning

There is an FDA stimulant boxed warning with dexmethylphenidate. This boxed warning states that dexmethylphenidate is a stimulant ADHD medication that is a Schedule II controlled substance. It has the potential for abuse, misuse, and addiction.

The boxed warning also states that this medication can increase the risk of stroke, heart attack, and sudden death, especially in individuals with heart conditions.

The FDA has recently added an updated warning to all extended-release ADHD medications, which would include dexmethylphenidate. Research shows that children under six taking extended-release stimulant medications experienced growth suppression and weight loss.

Children in this age group retain the drug longer than older children, leading to unwanted side effects. It's important to mention that ADHD Advisor only treats adults aged 18 and older..

Dexmethylphenidate vs. Other ADHD Medications

You may be able to access CHADD on stimulant medication to find out more about various ADHD medications and compare them for yourself. But let's break down some of the other ADHD medications and how they compare to dexmethylphenidate now.

Dexmethylphenidate vs Methylphenidate (Ritalin, Concerta)

Dexmethylphenidate and methylphenidate are in the same stimulant drug family but with different active components. Methylphenidate is a combination of both d- and l-isomers, and dexmethylphenidate is more selective, only using the more active d-isomer. 

As such, dextroamphetamine is about twice as potent as methylphenidate and can be taken at a much lower dose, which in turn may lead to fewer side effects than methylphenidate. 

Both classes can help to reduce impulsivity, inattention, and focus problems. Dexmethylphenidate is available in both extended-release and immediate-release forms, and Ritalin is the immediate-release form of methylphenidate; Concerta is the extended-release form. Methylphenidate is available in various forms, including a liquid and a chewable tablet for those who find it difficult to swallow pills.

Dexmethylphenidate vs Amphetamines (Adderall, Vyvanse)

Dexmethylphenidate and amphetamines like Vyvanse and Adderall are all stimulant medications used to treat ADHD, but have a different mechanism of action. Dexmethylphenidate mainly blocks the reabsorption of dopamine and norepinephrine, helping to increase the levels of these two neurotransmitters in the prefrontal cortex area of the brain. Amphetamines block the reabsorption or reuptake of neurotransmitters, too, and also help stimulate the release of new neurotransmitters.

Both classes of stimulants help increase attention and focus, and both are available in immediate- and extended-release formulations. 

But tolerability and effectiveness may differ across classes. Some people may be able to take amphetamines, and others may feel that dexmethylphenidate provides a smoother experience.

Dexmethylphenidate vs Non-stimulants

Dexmethylphenidate and non-stimulants differ in many ways. First, dexmethylphenidate has a different mechanism of action than non-stimulants. Dexmethylphenidate works on both dopamine and norepinephrine, and non-stimulants tend to focus solely on norepinephrine to manage ADHD symptoms. 

Dexmethylphenidate has a much faster onset and stronger efficacy than the slower-acting non-stimulants. Because dexmethylphenidate is a controlled substance, it has a higher potential for abuse than non-stimulants, which are not considered controlled substances. Non-stimulants are often a better choice for individuals with substance use disorder.

ADHD Care with ADHD Advisor: Stimulant Prescriptions in Select States

ADHD can be successfully managed with therapy, non-stimulant, and stimulant medications according to the CDC ADHD treatment guidance. With ADHD Advisor, you could receive your ADHD medication online and therapy. We provide therapy and non-stimulant treatment for ADHD nationwide to adults aged 18 and older.

We also offer stimulant treatment, including dexmethylphenidate, if you live in an eligible state. For example, your online ADHD doctor in Florida can write you a prescription for stimulants if they determine you need it. Similarly, you can receive online Adderall in Texas if you live there and your doctor determines it is a necessary part of your treatment plan.

We help with your prescription fulfillment each month. ADHD Advisor's healthcare professionals can send your prescription to your pharmacy of choice and ensure that each consecutive prescription is filled for you. 

We do not bill insurance, but we provide a superbill that you can submit for possible reimbursement, depending on your provider. Let's now learn how to get diagnosed with ADHD online with ADHD Advisor.

Step-by-Step Process

Are you interested in learning how to get tested for ADHD online? All you need to do is follow these easy steps.

1. The first step is to take our online intake questionnaire. This intake will help us learn more about your medical history and your current ADHD symptoms.
2. Next, you will set up your ADHD telehealth evaluation with one of our healthcare providers. They will determine if you have ADHD.
3. After your assessment, your healthcare provider will create a unique treatment plan for you. This plan can include therapy, non-stimulant medication, and stimulant treatment if appropriate and if you live in one of our qualifying states.
4. If you do live in one of our select states, you could possibly receive a prescription for dexmethylphenidate.
5. Finally, you will continue to receive follow-up care and ongoing monitoring. During these appointments, your provider may discuss symptom improvement and side effects, adjusting the dosage as necessary.

Access, Cost & Insurance

Dexmethylphenidate ADHD medication, is widely available at most US pharmacies as a lower-cost Focalin generic.  Most insurance companies do cover the generic, though a prior authorization may be required. 

The costs can vary by pharmacy, but the average cost of dexmethylphenidate ranges from $30 to $300. Extended-release and immediate-release also have different prices and dosages, but overall, generic dexmethylphenidate is cheaper than the brand-name Focalin.

ADHD Advisor does not bill any insurance company. We can provide you with a superbill that you may be able to submit to your insurance company, depending on your provider and plan.

FAQs

Is dexmethylphenidate the same as Focalin?

Yes, dexmethylphenidate is the generic ADHD medication equivalent of the brand-name Focalin. 

Is dexmethylphenidate addictive?

Yes, dexmethylphenidate is considered to be an addictive medication. The FDA and DEA classify it as a Schedule II controlled substance due to its high risk of abuse, misuse, and addiction. Misuse of this product increases the potential to develop a substance use disorder.  You should let your clinician know if you have a substance use disorder before starting dexmethylphenidate.

Can ADHD Advisor prescribe dexmethylphenidate?

Yes, ADHD Advisor can prescribe dexmethylphenidate to adults who are 18 and older in select states.

If you do live in one of our qualifying states and your clinician determines that dexmethylphenidate is a good fit for you, then ADHD Advisor can assist with prescription fulfillment.

What are the main side effects?

The main side effects that come with taking dexmethylphenidate include insomnia, appetite loss, anxiety, weight loss, and the risk of developing a substance use disorder.

How does dexmethylphenidate compare to methylphenidate?

Dexmethylphenidate and methylphenidate belong to the same family of stimulant medications, but have different chemical structures. Dexmethylphenidate contains only the active d-isomer, which binds more selectively to receptors. 

In contrast, methylphenidate contains both the active d-isomer and the non-specific l-isomer. This makes dexmethylphenidate more potent than the racemic form of methylphenidate, which may help reduce some side effects.